How can Early-Onset Dementia be prevented?

In the quest to understand and combat young-onset dementia (YOD), a groundbreaking study has delved into previously unexplored territory, shedding light on modifiable risk factors that could revolutionize preventive initiatives. In a groundbreaking prospective cohort study utilizing data from the UK Biobank, researchers sought to unravel the factors associated with the incidence of YOD in individuals younger than 65 years without a dementia diagnosis at baseline. The study found many modifiable factors that were associated with young-onset dementia.

The study results were published in the journal JAMA Neurology.

Exploring the landscape of young-onset dementia (YOD) has been hindered by a lack of comprehensive information on modifiable risk factors. Hence, researchers conducted a prospective cohort study using data from the UK Biobank to examine factors that are associated with the incidence of YOD.

The study, conducted between 2006 and 2010 with follow-up until March 2021 in England and Scotland and until February 2018 in Wales, excluded participants aged 65 and older and those with dementia at baseline. A total of 39 potential risk factors were examined, categorized into domains such as sociodemographic, genetic, lifestyle, environmental, blood marker, cardiometabolic, psychiatric, and other factors. The association between the risk factors and the incidence of YOD was assessed using the Multivariable Cox proportional hazards regression analysis.

Findings:

• Among the extensive cohort of 356,052 participants included in the study, 197,036 (55.3%) were women, and the baseline mean age stood at 54.6 (with a standard deviation of 7.0) years.
• Throughout the extensive follow-up period encompassing 2,891,409 person-years, researchers observed 485 incident cases of young-onset dementia (YOD), with 251 of these cases occurring in men, representing 51.8% of the male population.
• This translated to an incidence rate of 16.8 per 100,000 person-years, with a 95% confidence interval ranging from 15.4 to 18.3.
• In the conclusive model, a profound exploration of factors revealed 15 variables significantly associated with an elevated risk of YOD.
• These factors encompassed a spectrum of influences, including lower levels of formal education, diminished socioeconomic status, possession of two apolipoprotein ε4 alleles, abstinence from alcohol use, the presence of alcohol use disorder, experiences of social isolation, vitamin D deficiency, elevated C-reactive protein levels, reduced handgrip strength, hearing impairment, orthostatic hypotension, a history of stroke, diabetes, heart disease, and the presence of depression.
• Each of these elements contributed distinctly to the heightened risk of young-onset dementia, forming a comprehensive understanding of the multifaceted factors implicated in the onset of this condition.

Thus, These factors, many of which are modifiable, provide crucial insights into potential avenues for dementia prevention initiatives. The study emphasizes the importance of addressing lifestyle, environmental, and health-related factors to mitigate the risk of YOD. The identification of modifiable risks opens new possibilities for therapeutic interventions and strengthens the foundation for comprehensive dementia prevention strategies tailored to a younger demographic.

As we delve deeper into the complexities of dementia, understanding and addressing modifiable risk factors not only enriches our knowledge but also paves the way for targeted interventions that can make a significant impact on the incidence of YOD.

Further reading: Hendriks S, Ranson JM, Peetoom K, et al. Risk Factors for Young-Onset Dementia in the UK Biobank. JAMA Neurol. Published online December 26, 2023. doi: 10.1001/jamaneurol.2023.4929